I was a sickly kid, the kind who caught every cold he came across and turned it into something worse — the kind that keeps a mother up at night and keeps a kid home from school. And the grief I would give her about missing school was worse than whatever ailed me. Yes, I was that kid.
We lived in a company town. The company owned the mill and our homes. And it ran a clinic with doctors, nurses, and a pharmacy. If you lived there, you could walk to the clinic, and it was free for company workers’ families. So that’s where my mom would first take me. I’d get a prescription, but I wouldn’t get better.
Eventually, when I showed no signs of improving and missed more than two or three days of school, my mother would take me to Dr. Shah. He wasn’t a company doctor. He practiced farther away, which meant my mom had to arrange transportation — we didn’t have our own — and he charged money.
Dr. Shah’s waiting room looked just as packed as the one at the company clinic. It smelled the same: disinfectant layered over the scent of sickness. But Dr. Shah was different. I don’t remember what he prescribed. I remember how he made my mother feel: calm, reassured, like she wasn’t overreacting by dragging her kid to yet another doctor. And whatever he gave me, I’d start feeling better in two or three days.
That pattern repeated enough times to plant something in me. Anytime my mom said she’d take me to Dr. Shah, I knew I’d get better soon and stop missing school. As a kid, I couldn’t put it into words. I can today: a good doctor can make you feel better before you start getting better.
Aside from a brief teenage urge to join the army, I never wanted to be anything else.
A good doctor can make you feel better before you start getting better.
The Question Nobody Taught You to Ask
I didn’t understand what Dr. Shah was doing until years later, when I watched Simon Sinek’s Start With Why TED Talk — one of the most-watched TED talks ever recorded.
Sinek makes a simple claim. Most people and organizations can tell you what they do. Some can tell you how they do it. Very few can tell you Why. Sinek calls his framework the Golden Circle: Why in the center, How around it, What on the outside. He argues that people who inspire others work from the inside out.
Apply that to Dr. Shah. His what was the same as the company clinic’s what: diagnose an infection, prescribe a medication. His how probably wasn’t radically different either — he was a good doctor, not a wizard. What was different was his Why, and I don’t think it was “treat infections.” I think it was closer to: make this family believe things will be okay.
It’s what my mother felt, what I felt, and why I’m writing a blog about healthcare instead of one about army life.
Why This Isn’t Just a Communication Trick
Sinek’s framework explains why saying your Why moves people and why it matters to motivate them to buy into your ideas. In his book Drive, Daniel Pink argues that people aren’t motivated mainly by rewards and punishments. They’re motivated by three things: autonomy, mastery, and purpose. In Pink’s terms, purpose means doing your work in service of something larger than yourself — which is just another name for a well-articulated Why.
Together, they give a fuller picture. Sinek tells you how to find and communicate your Why. Pink shares research showing that purpose isn’t decoration on top of good work. It’s one of the three things that makes work feel like something other than a job.
An Exercise Worth Doing
Here’s an exercise, borrowed loosely from Sinek’s work: write your Why in one sentence. Then check it against a single test. If that sentence could belong to any doctor, in any specialty, in any hospital, it isn’t actually yours yet. It’s too generic to move anyone, including you.
I’ll be honest: I didn’t find this blog’s Why at the start.
I started this blog with a hunch, not a sentence. After a year of writing, I could finally see the question every post had been circling, even if I hadn’t realized it. I didn’t think my way to it. I wrote my way to it, and then had to stop and ask what I’d actually been doing all along. The educational theorist Donald Schön called this reflection-on-action — the clarity that shows up afterward, when you sit with what you just did.
So do the exercise. But don’t be surprised if the honest answer shows up only a year from now, after many ordinary days of mundane struggle.
A clear Why doesn’t always arrive by thinking harder. Sometimes it arrives by doing the work long enough to see its shape.
The Bedside Version of the Same Question
I trained in addiction medicine, and the central technique of that field is called motivational interviewing. Its premise is simple: you cannot hand a patient their Why. Tell a patient why they should cut back on drinking, and you usually get verbal compliance in the moment, followed by a lack of follow-through. Ask a patient why they want to change — and actually wait for the answer — and you get something closer to their own Golden Circle. Their own reason moves them in a way yours never will.
This is Sinek’s argument, run in reverse. He tells organizations to lead with their Why. Motivational interviewing tells clinicians to draw the patient’s Why out of them instead of supplying one. Same principle, opposite direction — and if you’ve ever wondered why some patients appear to “comply” while others actually change, this is why.
The 1991 film The Doctor, starring William Hurt, tells the same lesson the hard way. A skilled, efficient surgeon spends the whole movie treating patients competently but coldly. Then he becomes a patient himself, and finally understands what it feels like to be on the receiving end of a conversation without a Why. Worth a watch, mostly because it will make you wince at least once.
The One Practice
The next time you encounter a patient who hasn’t been taking their medicine, don’t ask, “Why haven’t you been taking your medication?” That sounds like an accusation in disguise.
Try something more like: “What would it mean for you if this got better?” Then stop talking, and let them answer.
Once they answer, ask: “What would it mean for you if this stayed the same?” Same as before — let them get to their own answer. It may even work better if you write those two questions down and hand them over, so the patient can sit with them before the next appointment.
This one habit changes how you talk to one patient at a time. By itself, it does nothing for the meeting down the hall where people argue about productivity without ever saying out loud why any of it matters.
That meeting is Part 2.
This is Part 1 of a two-part series on Simon Sinek’s “Start With Why” framework, applied to physician leadership. Part 2 comes next week.
